不同探头放置方向剪切波传播速度在乳腺肿块良恶性鉴别诊断中的价值  

Differential diagnosis of shear wave velocity in benign and malignant breast tumors on different probe orientations

作　　者：黄媛[1] 邓又斌[1] 王立平[1] 罗志勇[1] 王志辉[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声科,武汉市430030

出　　处：《临床超声医学杂志》2016年第3期166-169,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨不同探头放置方向所测剪切波速度(SWV)在乳腺肿块良恶性中的定量鉴别诊断价值。方法对76例女性患者(123个乳腺肿块)进行剪切波弹性成像检查,测量乳腺肿块中心同一部位在横切、斜切、纵切面上的SWV,评价测值的差异;比较良恶性肿块的SWV最大值、最小值及两者差值预测乳腺肿块良恶性的ROC诊断曲线。结果乳腺肿块在3个切面中SWV的最小值与最大值比较差异均有统计学意义(均P<0.01)。乳腺肿块的SWV最大值与最小值的差值预测乳腺肿块良恶性的ROC诊断曲线较单一切面测值准确率更高。乳腺肿块SWV最大值、最小值及两者差值的ROC曲线下面积分别为0.571(P=0.379)、0.486(P=0.863)、0.603(P=0.204)。SWV最大值诊断值截点为2.51 m/s,其预测乳腺肿块良恶性的敏感性67%,特异性50%;SWV最小值诊断值截点为1.61 m/s,其预测乳腺肿块良恶性的敏感性53%,特异性50%;两者差值诊断值截点为0.64 m/s,其预测乳腺肿块良恶性的敏感性60%,特异性56%。SWV最大值、最小值与两者差值的诊断曲线下面积比较,差异均无统计学意义(Z=0.29、0.01,P=0.380、0.496)。结论改变探头放置方向时乳腺肿块的SWV有差异。应用不同探头放置方向所测SWV的差异可对乳腺肿块良恶性的鉴别诊断提供参考价值。Objective To discuss quantitative differential diagnostic value of shear wave velocity（SWV） in benign and malignant breast tumors on different probe orientations. Methods SWV were measured in 76 female patients（123 breast tumors）with the probe placed on transverse,longitudinal and 45 degree planes. ROC curves of the maximum SWV,the minimum SWV and the D-value between them in benign and malignant tumors were compared.Results The differences between the maximum and the minimum SWV in three planes were significant（P〈0.01）,and the value of that to predict the benign and malignant was higher accuracy in the D-value other than the value in a single plane. The area under ROC curves of the maximum SWV,the minimum SWV and the D-value were 0.571（P=0.379）, 0.486（P=0.863）, 0.603（P=0.204）,respectively. The cutoff of the maximum SWV was 2.51 m/s（sensitivity was 67%,specificity was 50%）. The cutoff of the minimum SWV was 1.61 m/s（sensitivity was 53%,specificity was 50%）.The cutoff of the D-value was 0.64 m/s（sensitivity was 60%,Specificity was 56%）.There was no significant difference of area under ROC curve among maximum SWV,minimum SWV and D- value（Z = 0. 29,0. 01,P =0.380,0.496）.Conclusion There are different SWV in breast tumors on different planes. Differences of SWV measured by different probe orientations can provide a reference value for the differential diagnosis of breast tumors.

关 键 词：超声检查 弹性成像 剪切波速度 乳腺肿块 良恶性 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]